基于德尔菲法构建社区居民疫苗素养量表

目的 构建社区居民疫苗素养量表。方法 应用德尔菲法对社区居民疫苗素养量表的备选评价指标开展两轮专家咨询，对指标重要性进行评分，计算评分的均数、变异系数、满分比及其筛选界值，最终确定量表各级指标。结果 共纳入15名专家，在两轮咨询中专家的积极系数均为100%,权威系数分别为0.81和0.82,协调系数分别为0.537(χ²=26.33,P<0.001)和0.583(χ²=58.30,P<0.001)。根据指标重要性评分和筛选界值，确定的最终量表包括3个一级指标、14个二级指标和30个三级指标；其中一级指标为知识素养、能力素养和决策素养。结论 构建的社区居民疫苗素养量表具有较好的信度和效度，可用于评价社区居民疫苗素养水平。     

新冠疫苗犹豫及其影响因素研究进展

 2020年暴发的新型冠状病毒肺炎疫情推动了新型冠状病毒疫苗(简称新冠疫苗)的研发和应用,但疫苗犹豫阻碍了新冠疫苗的普及接种。本文横向对比不同国家的新冠疫苗犹豫情况,结合已有的相关模型剖析影响新冠疫苗犹豫的因素,从而提出针对新冠疫苗犹豫的干预措施,以期为改善新冠疫苗犹豫提供参考。     

应用改良德尔菲法构建中国公众疫苗素养评价指标体系

目的 构建中国公众疫苗素养评价指标体系，为开发疫苗素养测量工具和评价标准提供理论依据。方法 采用文献分析法和专家访谈法，梳理疫苗素养评价指标池，利用改良的德尔菲法进行两轮专家咨询，筛选评价指标，分析指标评分和权重。结果 两轮专家咨询的问卷回收率均为100%,专家权威系数分别为0.82和0.81,专家意见协调系数分别为0.143、0.158(χ²=107.06,P<0.001;χ²=113.85,P<0.001)。第二轮咨询后评价指标的综合评分为4.05-4.75分，标准差为0.38-0.80,满分比为0.20-0.70,变异系数为0.08-0.20。根据综合评分和界值，最终构建的评价指标体系包括3个一级指标、6个二级指标和16个三级指标。在一级指标中，基本知识、基本信念和行为能力的权重分别为0.31、0.37和0.32。结论 本研究初步构建了中国公众疫苗素养评价指标体系，具有较高的精度和可靠性，可为开发公众疫苗素养调查量表提供参考。     

肺炎链球菌多糖疫苗在高风险成人中的应用

肺炎链球菌多糖疫苗(PPV)用于肺炎链球菌性疾病发病风险较高的2岁及以上儿童和成人预防肺炎链球菌性疾病。肺炎链球菌性疾病已经成为严重威胁人类健康的疾病之一,肺炎链球菌耐药性增加和耐药菌株的广泛传播,加大了肺炎链球菌性疾病的治疗难度,因此在高风险人群中推广接种肺炎链球菌疫苗具有重大的公共卫生意义。2012年中华预防医学会发布了《肺炎链球菌性疾病相关疫苗应用技术指南(2012版)》,将疫苗防治对象扩大到成人和老人。在我国,肺炎链球菌疫苗为第二类疫苗,尚未进入国家免疫规划,肺炎链球菌多糖疫苗在高风险成人中的应用才刚起步。本文就肺炎链球菌多糖疫苗在高风险成人中的应用现状进行综述,以供今后推进相关工作参考。     

肺炎链球菌疫苗抗原促进CRTH2(CD4~+CD294~+Th2)细胞增殖的实验研究

目的研究肺炎链球菌疫苗通过树突状细胞抗原递呈作用对CRTH2(CD4~+CD294~+Th2)细胞促增殖作用,为扩增及分选Th2细胞提供新方法。方法外周血单核细胞培养为树突状细胞,负载肺炎链球菌疫苗抗原后与T淋巴细胞共培养,CCK8法测定混合淋巴细胞反应,流式细胞仪分析DC及CRTH2细胞。结果肺炎链球菌疫苗可促进树突状细胞成熟,与TNF-a共同是DC成熟佐剂。DC负载肺炎链球菌疫苗抗原能使第5天CRTH2细胞亚群比率[(0.93±0.10)%]较首日[(0.70±0.02)%]升高,其绝对数也升高(均P0.05)。结论树突状细胞负载肺炎链球菌疫苗抗原能够促进CRTH2细胞增殖,可能是扩增Th2细胞有效方法之一。     

上海市长宁区老年人接种肺炎疫苗的影响因素调查

[目的]研究影响老年人接种肺炎疫苗的因素,提出促进老年人疫苗接种的策略和政策性建议。[方法]将500名老年人分为肺炎疫苗接种组和未接种组,自拟《老年人群肺炎疫苗知晓及接种情况调查表》,采用多因素回归分析方法,分析接种肺炎疫苗的影响因素及相关情况。[结果]老年人接种肺炎疫苗与其是否接种过流感疫苗、是否患过肺炎或老慢支等呼吸系统疾病、家庭人均月收入、对肺炎疫苗认知和是否患有其他慢性病有关;老年人文化程度、目前或退休前职业和家庭类型与其接种肺炎疫苗无关。[结论]加强广泛且有针对性的宣传对促进肺炎疫苗的接种具有重要作用。另外降低价格、纳入医保这些措施对肺炎疫苗的接种也具有促进作用。     

肺炎球菌疫苗及其应用

肺炎球菌可引起肺炎、脑膜炎、败血症、中耳炎等疾病,在2岁以下婴幼儿和老年人中发病率最高。实践证明,接种肺炎疫苗是安全、有效、经济的预防手段。本文介绍了肺炎球菌疫苗的发展及其免疫程序、免疫效果和应用,旨在为肺炎球菌疫苗在国内的推广应用提供参考。     

HIV感染者新型冠状病毒疫苗序贯加强免疫1例并文献复习

 人类免疫缺陷病毒(HIV)感染者存在不同程度的免疫缺陷,可能导致新型冠状病毒疫苗接种的有效性低于正常人群。HIV感染者应是新型冠状病毒疫苗加强针的优先群体,然而目前国内外尚未检索到HIV感染者接种新型冠状病毒灭活疫苗后使用腺病毒载体疫苗序贯加强免疫的报道。故本文报告1例HIV感染者,通过抗逆转录病毒治疗(ART)后,HIV得到良好抑制,CD4⁺T细胞计数正常,接种两剂新型冠状病毒灭活疫苗(国药集团中国生物北京生物制品研究所有限责任公司)后使用腺病毒载体疫苗(康希诺生物股份公司)序贯加强免疫,安全且具有高度免疫原性,为指导该人群新型冠状病毒疫苗接种提供参考依据。     

新型冠状病毒肺炎疫苗上市前疫苗犹豫情况及相关影响因素研究

目的 了解新型冠状病毒肺炎(简称新冠肺炎)疫苗上市前的疫苗犹豫发生情况及相关影响因素,为在疫苗上市早期采取针对性的干预措施提供科学依据.方法 自行设计调查问卷并通过网络发放,比较疫苗犹豫者和接受者在社会人口学信息、对新冠肺炎的认知情况、对疫苗的一般性认知情况,以及信心、自满和便利性等维度的差异.采用单因素和多因素log...     

新型冠状病毒疫苗研发策略综述

席卷全球的新型冠状病毒肺炎疫情给人类的生命健康安全带来巨大威胁,疫苗是防控疫情最为经济有效的手段。疫情暴发后,全球医药企业与科研机构快速启动了新型冠状病毒疫苗的研发,疫苗设计策略主要包括灭活疫苗、病毒载体疫苗、亚单位疫苗、减毒活疫苗和核酸疫苗等,经历1年的多方努力,目前已有多款疫苗相继公布Ⅲ期临床数据并获得紧急使用权限甚至被批准上市。本文将重点介绍新型冠状病毒疫苗免疫原靶标的选择,梳理当前不同类型疫苗的研究进展,并阐述新冠疫苗所面临的主要问题,以期为疫苗后续的改进提供有益借鉴。     

The effect of health literacy on COVID-19 vaccine hesitancy among community population in China: The moderating role of stress

BackgroundThe public’s hesitant attitude is a major subjective barrier in promoting vaccination against COVID-19 to build herd immunity. The current study aimed to address how individual factors such as health literacy and perceived stress affect people’s vaccine hesitancy of COVID-19 vaccine, and to provide insights for tailoring vaccine-promotion strategies.MethodsWith structured questionnaires, an online survey was conducted to address the relationship between the health literacy, perceived stress, and COVID-19 vaccine hesitancy among community population in mainland, China. Moderated analysis was conducted to test the effect of health literacy on vaccine hesitancy among people with different levels of perceived stress.Results560 responses were collected in total. 39.8% of the participants reported vaccine hesitancy, and this rate was higher among younger people and female. Moreover, people with higher level of health literacy showed reduced vaccine hesitancy, while this effect was only significant among those with low or moderate level of stress. For people with high level of stress, no significant effect of health literacy was found.ConclusionsThe findings suggest that increasing people’s health literacy could lead to reduced vaccine hesitancy in community sample. However, this effect disappeared when the stress level was high, suggesting other promotion services may need to be developed to increase the acceptance of COVID-19 vaccine. In conclusion, vaccine promotion strategies should be tailored for different populations, with taking account of individual’s health literacy and perceived stress.     

Relationship of pneumococcal and influenza vaccination frequency with health literacy in the rural population in Turkey

IntroductionVaccines have been shown to prevent illness, disability and death from vaccine-preventable diseases. The purpose of our study was to analyze the influenza and pneumococcal vaccination status of patients, the factors that influence the uptake of influenza/pneumococcal vaccination and the effects of health literacy (HL) on vaccination.Materials and methodsIn this cross-sectional study, demographic characteristics, comorbid diseases and the pneumococcal and influenza vaccination status in previous years were recorded for each patient. The Turkish version of the European Health Literacy Survey Questionnaire (HLS-EU-Q47) was used to assess HL.ResultsA total of 350 patients were enrolled in the study. A total of 6.3% of patients had received both vaccines. 20% of subjects were vaccinated with influenza vaccine and 11.1% of the subjects were vaccinated with pneumococcal vaccine. Overall HL was insufficient for 70.9%, problematic for 20.6%, sufficient for 7.1% and excellent for 14.2% of patients. Patients who had pneumococcal and influenza vaccination had higher disease prevention HL scores (p = 0.013, p = 0.001; respectively).DiscussionAn insufficient HL level was found to be much higher than previous studies. It was observed that an increase in disease prevention HL was associated with a rise in the rate of pneumococcal and influenza vaccination.     

The mediating effect of health literacy on COVID-19 vaccine confidence among a diverse sample of urban adults in Boston and Chicago

BackgroundA high rate of COVID-19 vaccination is critical to reduce morbidity and mortality related to infection and to control the COVID-19 pandemic. Understanding the factors that influence vaccine confidence can inform policies and programs aimed at vaccine promotion. We examined the impact of health literacy on COVID-19 vaccine confidence among a diverse sample of adults living in two major metropolitan areas.MethodsQuestionnaire data from adults participating in an observational study conducted in Boston and Chicago from September 2018 through March 2021 were examined using path analyses to determine whether health literacy mediates the relationship between demographic variables and vaccine confidence, as measured by an adapted Vaccine Confidence Index (aVCI).ResultsParticipants (N = 273) were on average 49 years old, 63 % female, 4 % non-Hispanic Asian, 25 % Hispanic, 30 % non-Hispanic white, and 40 % non-Hispanic Black. Using non-Hispanic white and other race as the reference category, Black race and Hispanic ethnicity were associated with lower aVCI (−0.76, 95 % CI −1.00 to −0.50; −0.52, 95 % CI −0.80 to −0.27, total effects from a model excluding other covariates). Lower education was also associated with lower aVCI (using college or more as the reference, −0.73 for 12th grade or less, 95 % CI −0.93 to −0.47; −0.73 for some college/associate's/technical degree, 95 % CI −1.05 to −0.39). Health literacy partially mediated these effects for Black and Hispanic participants and those with lower education (indirect effects −0.19 and −0.19 for Black race and Hispanic ethnicity; 0.27 for 12th grade or less; −0.15 for some college/associate's/technical degree).ConclusionsLower levels of education, Black race, and Hispanic ethnicity were associated with lower scores on health literacy, which in turn were associated with lower vaccine confidence. Our findings suggest that efforts to improve health literacy may improve vaccine confidence, which in turn may improve vaccination rates and vaccine equity.Clinical Trials Number: NCT03584490.     

COVID-19 vaccine literacy and vaccine hesitancy among pregnant women and mothers of young children in Japan

BackgroundDelays in the spread of vaccination have been recognized as an urgent public health issue in the context of the COVID-19 pandemic. Vaccine literacy (VL) is a critical determinant of vaccine uptake; however, little is known about VL among pregnant women and mothers of young children.MethodsWe analyzed data from a nationwide, cross-sectional internet survey in Japan on VL and vaccine hesitancy, conducted with 1,639 pregnant women and 5,688 mothers of young children who had given birth after July 2019, between July 24 and August 30, 2021.ResultsVaccine hesitancy was observed in 51.1 % of pregnant women and 31.9 % of mothers of young children. The risk of vaccine hesitancy was significantly higher among pregnant women with lower interactive/critical skills (risk ratio [RR] 2.10, 95 % confidence interval [CI] 1.59, 2.78, p < 0.001), although functional skills did not significantly correlate with vaccine hesitancy. For mothers of young children, we found a significantly higher risk of vaccine hesitancy among those with low VL functional skills (RR 1.38, 95 % CI 1.19, 1.61), p < 0.001) and low interactive/critical skills (RR 1.29, 95 % CI 1.10, 1.50, p = 0.001).ConclusionsOur findings suggest that aiding individuals to correctly evaluate vaccine-related information is critical for improving vaccine acceptance rates among both pregnant women and mothers of young children. Meanwhile, improving the comprehensibility of communication toolkits may be important for women with children but have a limited effect among pregnant women.     

The effects of parent’s health literacy and health beliefs on vaccine hesitancy

Parental vaccine hesitancy is a key factor influencing children’s vaccination against infectious diseases such as the COVID-19. The current study aims to investigate how parent’s health literacy and health belief affect parental hesitancy toward the COVID-19 vaccination, and navigate effective measures to help parents make vaccination decision for children. A mixed-mode web survey was conducted among parents of children aged 3–11 years. Parental vaccine hesitancy, health literacy, and health beliefs were assessed. Parallel mediation model examined whether the association between parent's health literacy and vaccine hesitancy was mediated by health beliefs. In total, 11.3% of the 346 participants reported vaccine hesitancy. Hesitant parents were more likely to be he mother (Father: 4.5%; Mother: 12.9%) and with children having allergic issues (Allergic: 18.3%; Non-allergic: 9.8%). Meanwhile, parents with lower health literacy were more likely to show hesitancy towards vaccinating their children (β = −6.87, 95% CI = [−10.50, −3.11]). This relationship was partially mediated by more perceived barriers in vaccination (β = −2.53, 95%CI = [−4.09, −1.02]), but not other health beliefs. In other words, parents with better health literacy may perceive fewer barriers in making vaccination decision for their children, thus being less hesitant. Accordingly, healthcare professionals and policy makers could design education service to promote parents’ health literacy, and remove the perceived barriers as well as increase their confidence in following the COVID-19 vaccine guidance for children.     

Health literacy: addressing the health and education divide

Health literacy as a discrete form of literacy is becoming increasingly important for social, economic and health development. The positive and multiplier effects of education and general literacy on population health, particularly women's health, are well known and researched. However, a closer analysis of the current HIV/AIDS epidemics, especially in Africa, indicates a complex interface between general literacy and health literacy. While general literacy is an important determinant of health, it is not sufficient to address the major health challenges facing developing and developed societies. As a contribution to the health literacy forum in Health Promotion International, this paper reviews concepts and definitions of literacy and health literacy, and raises conceptual, measurement and strategic challenges. It proposes to develop a set of indicators to quantify health literacy using the experience gained in national literacy surveys around the world. A health literacy index could become an important composite measure of the outcome of health promotion and prevention activities, could document the health competence and capabilities of the population of a given country, community or group and relate it to a set of health, social and economic outcomes.     

Developmentally appropriate literacy goals for preschool and kindergarten classrooms

A major goal of our society's educational system is for children to become literate. Although agreement exists regarding the importance of literacy, controversy surrounds the timing of literacy instruction and the methods used to teach literacy skills. While most reading curricula involve formal instruction, this paper proposes that informal instruction is more developmentally appropriate for four-and five-year-olds. Research has begun to document the acquisition of literacy-related knowledge and skills prior to formal instruction in learning environments where informal instruction occurs, i.e. kindergartens, day care centers, and home environments.

The following five goals are offered as the basis of a developmentally appropriate literacy curriculum: [1] Encourage an awareness of how reading and writing are useful. [2] Develop listening comprehension skills. [3] Develop conceptual knowledge. [4] Develop oral language skills, and [5] Explore the process of communicating through written language. A rationale for each goal is given, along with example activities using informal instruction.     

Early teaching of Chinese literacy skills and later literacy outcomes

This study followed 88 children in Beijing and Hong Kong for three years to investigate the relationships between the early teaching of literacy skills and later literacy outcomes. The children were administered the Preschool and Primary Chinese Literacy Scale at the age of five years, and three years later. Their parents and teachers reported on their involvement in literacy teaching, the home/classroom literacy environment and their beliefs about language learning. Findings showed that the Hong Kong cohort significantly surpassed their Beijing counterparts in literacy attainments at age five and age eight. After controlling for age, site, maternal education and teacher qualification, formal literacy activities in early childhood significantly contributed to literacy attainment at primary school, whereas informal literacy experiences did not. Results suggest that the complicated nature of Chinese orthography may make early instruction particularly valuable in Chinese literacy acquisition. The psycholinguistic, pedagogical and sociocontextual accounts and implications of these findings are discussed.     

Understanding health literacy: an expanded model

A long and yet unfinished history of investigating how individual capabilities and social processes explain or predict health indicates that poor education, low literacy, poor health and early death are strongly linked around the world. However, the complexity of those relationships is not fully understood. In this article, we propose an expanded model of health literacy characterized by four domains: fundamental literacy (reading, writing, speaking and numeracy), science literacy, civic literacy and cultural literacy. To explore the utility of this model, we examine selected pieces of the public discourse about terrorism and bioterrorism that dominated the mass media during the anthrax threat in the United States during 2001. We conclude that this model of health literacy is useful to analyze health communication, to aid in constructing more understandable and appropriate health communication, and ultimately can lead to the development of a new measure to assess health literacy skills in individuals.     

健康传播中健康素养和媒介素养的教育反思

针对健康传播现状,笔者以"大卫生"和"大传播"观为框架,从媒介素养与健康素养教育角度探讨我国健康传播的健康生态营造。